‘I used to think that the brain was the most wonderful organ in my body. Then I realized who was telling me this’ Emo Philips

Undermining cognitive fusion

Key targets for cognitive defusion Help clients see thoughts as what they are – just thoughts – so that thoughts can be responded to in terms of their workability given the clients values, rather than in terms of their literal meaning Help clients attend to thinking and experiencing as an on-going behavioural process and away from the literal meaning of the contents of the mind

What is defusion ACT argues that the problem with human suffering, as it relates to thoughts, is not that we have the ‘wrong thoughts’, but rather that we spend too much time ‘in them’ or ‘looking from them’, rather than simply looking at them and observing them Defusion attempts to allow the client see thoughts as an on-going behaviour that can be watched, and not taken too seriously at times when they are unhelpful Clients are encouraged to look at thoughts from the perspective of workability, and not see them as literal truth

A common misunderstanding is that our thoughts cause our behaviour For example, if we asked someone why they stood in the corner all night at a party, a plausible answer might be ‘I was too worried I would embarrass myself’. This thought (worry) caused the subsequent action – withdrawal ACT holds that Defusion, being able to stand away from our thoughts, will enable us to take effective action in spite of them Essentially Defusion involves changing our relationship with our thoughts and understanding that thoughts are just words created from our history. In each situation we get to evaluate whether our thoughts are being helpful or unhelpful

A common technique can be used to illustrate this point Imagine a glass of milk, think about what it looks like, what it tastes like, what it smells like Now repeat the word milk over and over for 30 seconds What happened?

Most people find that; The word temporarily loses some of its meaning, And other functions dominate awareness, like the strangeness of it sound In a therapy situation such an exercise would be done with a self relevant word – worthless The exercise aims to reduce literal content The idea is to show that this is just a word

When, how and why to do defusion Defusion is most powerful with clients that tend to hold the literal meaning of their thoughts to be true Some who has the thought that they were ‘bad’, would believe fully such a thought, assuming it is ‘true’ There are many ways to help people become less fused with their thoughts, these include; paradox, meditative exercises, experiential exercises and metaphor

Once Defusion is reached clients are encouraged to focus on effective action in spite of the negative thoughts they may be having Simple example – John’s alarm didn’t go off, he was late for work. Because of this he shouted at his wife, he had fused with the thought ‘she didn’t set my alarm and made me late for work’. If in that moment, John had the ability to see his thought from a distance, and keep in contact with his value of being a loving husband, he would have seen that shouting was not effective action in that context

Some defusion exercises Defusion exercises attempt to reduce the literal quality of the thought, weakening the tendency to treat the thought as what it refers to (truth) rather than what it actually is (a thought) Note: the result of Defusion should be a lowered attachment to private events, not a change in their frequency or form Some examples include; Singing the thought Buying a thought Speaking the thought in a silly voice Watching your thoughts on a TV screen Giving the thoughts a shape, size, colour or speed Thanking your mind for an unhelpful thought Label the process of thinking; I'm having the thought that I'm worthless Mindfully observing the thoughts like leaves on a stream

Lets start a short exercise; Bring to mind a friend, who has had some psychological troubles that have come to you with. Think of three thoughts that this person has about himself or herself, his or her life, or his or her future that are difficult for this friend. Record these on a sheet. If you cant think of anyone create a client in your head. Try to be specific with the thoughts We’ll come back to this later

Creating distance between the thought and thinker, feeling and feeler ACT aims to allow clients to see that thoughts and feelings are something clients have rather than something they are There are a few ways to apply this principle;

Objectify language We all have a great deal of experience dealing with objects in our environment as separate from ourselves By attributing our thoughts as objects to be viewed the same distance can be achieved Objectifying thoughts can help clients interact with their thought in a more flexible and practical way Your thoughts as a tool metaphor The bullying passengers on a bus metaphor The taking your mind for a walk metaphor (naming your mind)

Looking at thoughts rather than from thoughts This is the difference between having a thought and buying a thought We can do this by emphasizing the fact that we constantly speak to ourselves or by practicing various metaphors Leaves on a stream Soldiers in a parade Listen to this transcript

Reveal the hidden properties of language Evaluation versus description The idea of this is to allow the client to step away from their thoughts and see exactly what is happening when they confuse the two The ‘bad cup’ metaphor is helpful here

Undermining larger sets of verbal relations Story telling and reason giving Lets look at a transcript of how story telling builds and can ultimately be unhelpful Examine the workability of the stories If God came down from Heaven and said, you are 100% right about why you have a disorder, how would that help?

Therapeutic stance The previous slides detail Defusion metaphors and exercises However it is important that these be integrated into the general flow of the session And not just be listed didactically Importantly, Defusion work in therapy never ends, and is used constantly through each ACT process In any given situation, the primary focus is on whether buying a thought would move the client toward a more vital, values based life

Underneath are some specific techniques used for practicing Defusion in the ongoing flow of the session Verbal conventions I'm having the thought that Thanking your mind Replacing ‘but’ with ‘and’ Metaphor reminding Coming back to metaphors used previously Listen to this manuscript Teaching the client to recognize fusion

Go back to the three thoughts you listed at the beginning of this lecture, now that you have learned a little about Defusion techniques, consider one technique you could use for each of the thoughts you recorded And no onto the video!